Ridryder 911

What amazes me is so many EMT's that have never taken a formal medical terminology course. I took an 8 week course, during my basic EMT. I can tell of those who have not by mispronunciation of words, mis-spelling, and improper use. I highly recommend such a course to anyone serious about their profession, and it definitely aids in anatomy & physiology. Be safe, R/R 911

EMT's who criticize Paramedics and don't understand what "focused assessments"...are...! Be safe, R/R 911

In my opinion nasal tracheal intubation is basically the same as oral intubation, either with spontaneous respiratory drive or using magills. The same true as digital intubation, on trauma patients. Intubation is intubation, putting a tube int tracheal opening..no big deal. Intubation should occur when ever the patient needs to have the airway secured or unable maintain ventilation & perfusion (V/Q ratio)...just common sense & normal airway control.... Be safe, R/R 911

As previous posted, each service and institution is supposed to have an approved abbreviation listings for charting. This is one of the first items the attorney reviews as he goes though your chart and procedures..... Be safe, R/R 911

Okay, maybe I missed it, but how can a deaf person perform simple procedures like communicate on the radio?.. to receive calls, orders, etc.. or to hear SHOTS FIRED!... Be safe, R/R 911

Anything can be done if you set your mind to it... I am > 40 work an everage of 96 -120 a week & go to grad school full time.. so it is what is important to you at the time.. Be safe, R/R 911

I understand and agree with mos is being said. It would be ideal to have concurrent education & life experiences; however; this is not realistic anymore. Not that it can't occur, but just getting more difficult. Yes, experience is essential. But, I believe most of us that have been in life longer than others .. understand what we mean by "life experiences".. understanding life is more "gray" than black & white. This can occur at given ages, but usually over all maturity increases with age (hopefully) . The art of medicine is to be able to apply all those understandings of science, life, and emotions.. That is why there is never ...one way to handle a situation. Be safe, R/R 911

Actually, you may be a taxi cab driver or they may even call you an ambulance driver... but, I am a Paramedic & was one when you were still in diapers.. so, I don't have to worry about getting over it. I have way too many ... you call, we haul...ambulance drivers & yes those deserve minimum wage. Actually, according to Medicare guidelines, you are to inform the patient if knowingly, that services are not to be covered. Hmmm.. I smell medicare fraud.... the same on taking granny to the dentist or shopping or even returning home from a ER or hospital, if they are ambulatory. Sure, you have to guarantee transports....as you state "Emergencies" in which case these are not & can not be classified as. Too many municipal uses policy to ensure the numbers look good. Now on "dumping" on the ER, if you really did your job appropriately, you should 1) offer to seek other transportation if the client needs to be transported 2) Provide transportation, for them if they have no other means with them understanding that they will receive a bill and chances are insurance and M/C may not cover it. ... if that the case..why not take them to an urgent care center instead of an ER. ?... Medicare is quite aware of EMS practices of "writing" things off.. for partial reimbursement. With good policies and active medical director, some of these transports can be eliminated. You will always have abusers of the system. As part of the EMS profession and job, don't always take things as face value. If local policy dictates, fine.. then, you have to accept or change things.. With the increase aging population, decreased ER availability, new policies may have to be developed and looked at if this trend increases. Be safe, R/R 911

Okay, i am for ADA and all that stuff when applicable. So I think, we should having deaf EMT's work in radio dispatch, the blind EMT's be strictly assigned as EVO, and the bi-lat amputee with prosthetic "hook" arms be responsible for starting I.V.'s and placing urinary catheters in place as well, ... For those who actually are deaf (although there is not a legal definition of deafness as compared with blindness) I'll use the standard definition "can not hear"... The U.S. Department of Labor, definition of EMT :These workers risk noise-induced hearing loss from sirens and back injuries from lifting patients. In addition, EMTs and paramedics may be exposed to diseases such as hepatitis-B and AIDS, as well as violence from drug overdose victims or mentally unstable patients. The work is not only physically strenuous, but can be stressful, sometimes involving life-or-death situations and suffering patients. Nonetheless, many people find the work exciting and challenging and enjoy the opportunity to help others. furthermore.......... EMTs and paramedics should be emotionally stable, have good dexterity, agility, and physical coordination, and be able to lift and carry heavy loads. They also need good eyesight (corrective lenses may be used) with accurate color vision So we can conclude that they are responsible for the patient assessment using verbal communication techniques, visual examination, tactile examination and comprehension and interpretation of those findings. Shame on the EMS directors that disallows adherence of qualifications. What is next? Again, I not against physically challenged or impairment, just certain jobs require senses... i.e a micro lab tech has to see... etc.. can we adapt special programs for those with disabilities .. you bet and should we .. definitely yes... Be safe, R/R 911

I disagree... actually, my job is not a taxi cab driver. . it is to assess and treat & stabilize patients for the transportation to the hospital. I agree, if the patient deeds transportation or certain circumstances .. yes transport. But the "U called..... We haul".. mentality is wrong. Worried about litigation... just lie to the patient/client.. good or bad. One, you have just lost respect from them (especially when they receive that $800 EMS bill) and could be held liable or accountable if you did not warn them that insurance or medicare may not be responsible for the bill if not warranted as a deemed emergency. Far AMA or refusals, yes one definitely needs to be careful and yes try to convince to seek medial help if they need to do so. But, if the client is alert, orientated of event and have no outstanding special circumstances ( i.e mental capability) they have a right to refuse treatment & transport. Be sure to advise of potential risks and dangers... simple "Death". For as "hospitals problem".. hey!, do your job.. don't pawn it off on a health care professional. Want to know why there is so much over crowding and diversions ? .... Your incorrect on the number one law suit .. it is not refusals.. it is "improper use of stretchers & injuries related to stretchers".. Be safe, R/R 911

My goal is to make the National Registry to have to develop a new certificate. I received my "20 year maintaining certification for Paramedic" years ago... I want a 50 yr "Gold one !"...LOL Be safe, R/R 911

We would call a taxi or friend etc. since it was now not considered an emergency, it was their responsibility like any other event to go some where. You would not call the Police to take you grocery shopping... or to the Dr.'s clinic.. etc.. Be safe, R/R 911

I guess I will have to change my mind on allowing deaf people....obviously after reading some of the post, it has convinced me we already allow anacephalics... Be safe, R/R 911

At a EMS I once worked at used to have a policy that allowed us to not transport requiring parties if there were non-emergency warrented transports. As a Field Supv. I was routinely called to make the final determination. They were like the calls discussed. Finger lacc < 1 cm, fish finned, very minor inj. etc... of course the policy required medical control to be advised etc... it was nice. The response from the patient usually was " I couldn't afford a taxi".. It is a shame othe EMS does not thave the same. Be safe, R/R 911

Thanks, I knew I had posted it somewhere.... Be safe, R/R 911

I too agree at least 21 for Paramedic. I am sure insurance companies have enough research on age levels. the problem is too many areas are utilizing Basics and Intermediates as their sole providers for EMS, therefore the age would have to be included as well. Maturity, is not always based upon "life experiences" if it was, there would be plenty of 19 year olds with it. Part of the reason for age requirements is based on more consistent interpretation and application of those life experiences. As well, as most know 90% of this job is not medical related but, having an understanding of the situation, and directing or taking control of crisis moment. Again, research has shown that there is a point of age where the brain develops and more rationale decisions can be made. Far as older age, I believe there should not be a restriction as long as you are mentally, & physically fit to perform the duties. EMS weeds out more than most other health care providers, by requiring CEU's, refreshers and continuous certification levels. Be safe, R/R 911

Well I think I have had some blind ones.... they way the drove back & hit every bump... Oh, I think my Director is deaf as well, he does ot hear a word we say to him....lol Be safe, R/R 911

So actually your physicians P.A is assessing you ... why not just see the P.A. then. Very trusting physician... This is just one profession, that can not cut corners on abilites. .... Be safe, R/R 911

.. LMAO... :laughing3: .. Well he wrote they appearantly loved him, since he never heard them complain...LOL.. I can see the foreward .. thanks to all those patients, that I missed your wheezing, and to all those that were screaming in the house due to the fire, that i couldn't hear you .. sorry! Be safe, R/R 911

Dust you would hate most ER's now.. In our 20 bed (acute side), we only have 4 manual B/P cuffs & they are located on the crash cart. I spec the equipment for the rooms, each room has a electronic B/P , with (continuous 15 lead, if you want) EKG, SpO2 & side stream EtC02 as well.... of course you can't forget telephone, cable t.v. as well.. LOL I finally have most of the new nurses understand, if you have a questionable BP to get a manual. OF course there are dopplers on each cart as well. So far at least >90% of the time they are within the ranges, when tested against manual. For as costs. you can add BP to LP 12 or other monitors for small nominal fee...not enough that would change budget concerns for benefits, but I do understand your statement. But, on those critical care transports with q 5-15 min v.s., 3 IV's infusing, plus blood, and ventilator ... it makes it nice.... you can print out, in the end.. I routine spot check... as I encourage students to do the same. Like in the unit, you should periodically routinely auscultate a B/P, unless they have an art line in... Like I said it is like any other diagnostic equipment. you need to have multiple sources and use clinical judgment... Be safe, R/R 911

I guess those that "could care less" or would have them work .. could justify missing a pneumothorax.. or even hearing the chief complaint ? Would you go to a deaf physician ?.. especially if you were having a cough ?.. . Would we also allow a blind person as well ?.. I just find it funny they can vote,but are unable to discuss why such?..

I work with a vertically challenged medic.. they claim that they cannot lift due to their height.. however; they have now became accustomed with everyone lifting for them, even their jumpbags.. I have worked with short partners before, even in the old days of actually lifting patients out of the rig (2 man stretcher) .. & didn't have any troubles. They learned they have to be in good shape... <<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<< I am wondering for those that voted to allow them to work, how they justified their answer or reason behind it...? Be safe, R/R 911

They should had never to be allowed into the program. Nothng against disabilites by far, but part of the job decription is to be able to auscultate, communicate verbally, etc.. Pateint assement is based upon so many of our senses.. This was a bad deal to allow this.. the should had been placed into another division that they could perfom at. Be sfe, R/R 911

Never trust the needle on the dial "jumping" as a sign of a BP. The arterial pulsation can give a false reading. The cut off value when you hear the korotkoff sound ..Most EMT's are not aware of the 4 sounds of a blood pressure. Pump the cuff usually 20 points above the last hearing of the pulsation. Palpations of blood pressure is not an accurate finding,but commonly used for systolic finding. Nothing irritates me more than someone that reports a BP in odd numbers, using a manual cuff ! :twisted: Be safe, R/R 911

That happens all the time in every EMS I have seen... at shift change time. Never fails, to get a call at shift change.. should be no squabbles, but it does occur. Usually, when a call comes in 3-5 minutes until shift change. We have a policy, if you are coming onto duty and your present.. you go!... There is no reason for someone to stay over for a call and the company to pay over time. You are also getting a fresh creew member. For as firng them.. hmm depnds if this a repeat thing or circumstances. More invistigation, certaiinly some form of punishment. Be safe, R/R 911